This article is also available in Spanish: Dedo en gatilloDedo en gatillo (topic.cfm?topic=A00464).

Trigger finger limits finger movement. When you try to straighten your finger, it
will lock or catch before popping out straight.

Trigger finger is a condition that affects the tendons in your fingers or thumb.

In this photo, the patient's finger sticks in the bent position as she tries to straighten
it.

Anatomy

The tendon sheath attaches to the finger bones and keeps the flexor tendon in place
as it moves.

Tendons are tissues that connect muscles to bone. When muscles contract, tendons pull
on bones. This is what causes some parts of the body to move.

The muscles that move the fingers and thumb are located in the forearm, above the
wrist. Long tendons — called the flexor tendons — extend from the muscles through
the wrist and attach to the small bones of the fingers and thumb.

These flexor tendons control the movements of the fingers and thumb. When you bend
or straighten your finger, the flexor tendon slides through a snug tunnel, called
the tendon sheath, that keeps the tendon in place next to the bones.

The flexor tendon can become irritated as it slides through the tendon sheath tunnel.
As it becomes more and more irritated, the tendon may thicken and nodules may form,
making its passage through the tunnel more difficult.

The tendon sheath may also thicken, causing the opening of the tunnel to become smaller.

If you have trigger finger, the tendon becomes momentarily stuck at the mouth of the
tendon sheath tunnel when you try to straighten your finger. You might feel a pop
as the tendon slips through the tight area and your finger will suddenly shoot straight
out.

The thickened nodule on the flexor tendon strikes the sheath tunnel, making it difficult
to straighten the finger.

Symptoms of trigger finger usually start without any injury, although they may follow
a period of heavy hand use. Symptoms may include:

A tender lump in your palm

Swelling

Catching or popping sensation in your finger or thumb joints

Pain when bending or straightening your finger

Stiffness and catching tend to be worse after inactivity, such as when you wake in
the morning. Your fingers will often loosen up as you move them.

Sometimes, when the tendon breaks free, it may feel like your finger joint is dislocating.
In severe cases of trigger finger, the finger cannot be straightened, even with help.
Sometimes, one or more fingers are affected.

Rest

If symptoms are mild, resting the finger may be enough to resolve the problem. Your
doctor may recommend a splint to keep your finger in a neutral, resting position.

Medications

Over-the-counter pain medications, such as non-steroidal anti-inflammatory medicines
(NSAIDS) or acetaminophen can be used to relieve the pain.

Steroid Injections

Your doctor may choose to inject a corticosteroid — a powerful anti-inflammatory medication
— into the tendon sheath. In some cases, this improves the problem only temporarily,and
another injection is needed. If two injections fail to resolve the problem, surgery
should be considered.

Injections are less likely to provide permanent relief if you have had the triggering
for a long time, or if you have an associated medical problem, like diabetes.

Trigger finger is not a dangerous condition. The decision to have surgery is a personal
one, based on how severe your symptoms are and whether nonsurgical options have failed.
In addition, if your finger is stuck in a bent position, your doctor may recommend
surgery to prevent permanent stiffness.

Surgical Procedure

The goal of surgery is to widen the opening of the tunnel so that the tendon can slide
through it more easily. This is usually done on an outpatient basis, meaning you will
not need to stay overnight at the hospital.

Most people are given an injection of local anesthesia to numb the hand for the procedure.

The surgery is performed through a small incision in the palm or sometimes with the
tip of a needle. The tendon sheath tunnel is cut. When it heals back together, the
sheath is looser and the tendon has more room to move through it.

AAOS does not endorse any treatments, procedures, products, or physicians referenced
herein. This information is provided as an educational service and is not intended
to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance
should consult his or her orthopaedic surgeon, or locate one in your area through
the AAOS "Find an Orthopaedist" program on this website.